Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 1;48(8S):S66-S70.
doi: 10.1097/OLQ.0000000000001473.

Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program

Jenna Norelli  1 , Maria Zlotorzynska, Travis Sanchez, Patrick S Sullivan
Affiliations

Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program

Jenna Norelli et al. Sex Transm Dis. .

Abstract

Background: Despite advances in implementing human immunodeficiency virus (HIV)/sexually transmitted infection (STI) services for men who have sex with men (MSM), many remain underserved because of barriers like stigma, low facility coverage, and provider competency. This article describes the implementation of centralized nationwide mailed HIV/STI home testing (CareKit).

Methods: The Emory Center for AIDS Research developed CareKit for research study participants to request HIV self-test kits, STI specimen collection kits, and condom/lubricant packs to be shipped to any mailing address in the United States. Sexually transmitted infection kits were customized according to study needs and could include materials to collect whole blood, dried blood spots, urine sample, and rectal and pharyngeal swab samples for syphilis, gonorrhea, and chlamydia testing. Specimens were mailed back to a central Clinical Laboratory Improvement Amendments-approved laboratory for testing, and results were returned to participants.

Results: CareKit was used by 12 MSM studies and mailed 1132 STI kits to 775 participants between January 2018 and March 2020. Participants returned 507 (45%) STI kits, which included 1594 individual specimens. Eighty-one kits (16%) had at least one positive STI test result: pharyngeal chlamydia (n = 7), pharyngeal gonorrhea (n = 11), rectal chlamydia (n = 15), rectal gonorrhea (n = 12), genital chlamydia (n = 6), genital gonorrhea (n = 1), and syphilis (n = 54). In this same 2-year period, 741 HIV self-test kits were mailed to 643 MSM.

Conclusions: CareKit successfully met studies' needs for home HIV/STI testing and diagnosed many STIs. These processes continue to be adapted for research and programs. The ability to mail home test kits has become increasingly important to reach those who may have limited access to health care services, particularly during the COVID-19 pandemic.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest and Sources of Support: The authors have no conflicts of interest to declare. This work was supported in part by grants from the Center for AIDS Research (P30 AI050409), the National Institutes of Health Adolescent Medicine Trials Network for HIV/AIDS Interventions and the University of North Carolina/Emory Center for Innovative Technology (1U19HD089881), the National Institute of Mental Health (1R01MH114692-01 and R01MH110358), the Centers for Disease Control and Prevention (1U01PS004977 and 1U01PS005181), the National Institute on Drug Abuse (5R01DA045612), and the National Institute of Allergy and Infectious Diseases (R21AI136657), and a contract from the Iowa Department of Public Health to the University of Iowa (5888AP32).

Figures

Figure 1
Figure 1
CareKit STI test kit process flow.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. CDC . Sexually Transmitted Disease Surveillance 2017. Atlanta, GA: US Department of Health and Human Services, CDC, 2018. Available at: https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearan.... Accessed January 8, 2021.
    1. Johnson Jones ML Chapin-Bardales J Bizune D, et al. . Extragenital chlamydia and gonorrhea among community venue–attending men who have sex with men—five cities, United States, 2017. MMWR Morb Mortal Wkly Rep 2019; 68:321–325. - PMC - PubMed
    1. Dewart CM Bernstein KT DeGroote NP, et al. . Prevalence of rectal chlamydial and gonococcal infections: A systematic review. Sex Transm Dis 2018; 45:287–293. - PMC - PubMed
    1. Workowski KA Bolan GA, Centers for Disease Control and Prevention . Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep 2015 Aug 28;64(33):924]. MMWR Recomm Rep 2015; 64(RR-03):1–137. - PMC - PubMed
    1. Lutz AR. Screening for asymptomatic extragenital gonorrhea and chlamydia in men who have sex with men: significance, recommendations, and options for overcoming barriers to testing. LGBT Health 2015; 2:27–34. - PubMed

Publication types